Friday, December 16, 2011

Time to Freak Out. Sensibly.

There is a reason I stick to relatively easily modifiable practices and how they might (possibly!) improve health and prevent disease. I like fun exercise, real food, wool socks in the wintertime, and sunshine. I don't like to think about the years of farm pesticide waste seeping into the groundwater, or the estrogenic compounds in plastic. Plastic compounds are ubiquitous and incredibly convenient. In all our packaged foods. Sippy cups. Tupperware. IV bags and tubing. Coating paper receipts. In the lining of canned foods and soda. The most famous is BPA (found primarily in receipts and number 7 plastic), but all sorts of plastic contain all sorts of weird compounds.

I like to live a relatively processed food and gluten free life - but philosophical ramblings about candy cigarettes aside, I don't dive across the table and grab the birthday cake out of my kid's hand at the party. (I'm not generally tempted by the birthday cake myself, as it is generally of the grocery-store azol-dye soybean oil frosted variety. There was an incredible ice cream cake at a recent party that I'll admit to stealing a few bites from). There's a line between living a somewhat normal life and being completely obsessed and anxiety-ridden about food, and I certainly don't want the kids to be obsessed and anxiety-ridden about food. Nor would I lie about my kids having celiac or peanut allergies - the last thing I want is a terrified preschool teacher calling me about the goldfish cracker my kid snatched from some other kid's lunch, and should she call an ambulance or what. Nothing is totally off-limits within reason, though the healthy stuff has to be consumed first, before the leftover Halloween candy. And yes, they do get gluten-free pretzels as a snack (they are cooked in palm oil). And sometimes those sugar-bombs otherwise known as raisins.

So we muddle through, minimizing harm, and the way I approach plastics is to slowly transition away from them and avoid heating anything (or putting hot food) in them. (I try not to think about those years and years of microwaved lean cuisines). I get milk delivered from a local organic dairy in glass bottles. Is that enough? Some (many of you, perhaps) would say no. But aluminum lunch containers are expensive (and have plastic lids that tend not to fit as closely as plastic on plastic), and many of the plastic ones I have are still serviceable and attractive. Canned foods are also tricky - on a mostly "paleo" "real foods" "avoiding processed food" diet the major canned foods will be coconut milk and tomato products (maybe canned pumpkin?). In general I made an effort to avoid these except for maybe once per week, figuring, again, the dose makes the poison, and tomato sauce makes anything more palatable for the kids (a variation of the old parenting trick of putting ketchup on everything.)

Ignorance is bliss, really. At the end of November a research letter was published in JAMA- "Canned Soup Consumption and Urinary Bisphenol A: A Randomized Crossover Trial." In this little Harvard School of Public Health Study, student and staff volunteers consumed 12 ounces of either fresh (prepared without canned ingredients) or canned (Progresso brand) soup daily for lunch (they were vegetarian varieties of course - this is HSPH!). For the first 5 day period, the soup was consumed daily. After a 2-day washout, the treatment assignments were reversed. Urine samples were taken on the 4th and 5th days of each phase. Urinary BPA was found in 100% of Progresso consumers and 77% of fresh soup consumers, and following the 5 days of canned soup, urinary BPA was 1221% higher than the urinary BPA of the fresh soup consumers.

"The increase in urinary BPA concentrations following canned soup consumption is likely a transient peak of uncertain duration. The effect of such intermittent elevations in urinary BPA concentration is unknown. The absolute urinary BPA concentrations observed following canned soup consumption are among the most extreme reported in a nonoccupational setting."

I have to admit I'd canned (heh heh) Progresso and other pre-prepared soups from my eating list a long time ago due to the biochemistry-happy omega-6 fest in the list of ingredients… as expected from any processed food maker trying to scratch a profit by using the least expensive commodity items. I try to use marinara sauce from a glass jar whenever possible (we'll ignore the plastic seal around the top), and I'm looking for good convenient alternatives to canned coconut milk… but the pantry still has some canned items, to be sure. And certainly the cardboard box variety of foods has plastic in the lining as well, right? I make more and more of my own bone broth, but sometimes you just need a bit of stock on hand. Am I being hopelessly neurotic and silly worrying about plastics, BPA, and canned items (and handling receipts as little as possible)?

Urine was collected from pregnant women at 16 and 26 weeks, and at birth) and later from the resultant babies at 1, 2, and 3 years of age. The results? Well, BPA was detected in >97% of the gestational and child urine samples. With adjustment for confounders, each 10-fold increase in gestational BPA concentrations was associated with more anxious and depressed behavior on standardized scales, along with poorer emotional control. This was true more of girl babies than of boys. The urinary levels in the children themselves didn't make much difference in behavior, and there was no difference between girls and boys.

There was another scary article about exposure of infants to breastfeeding moms replete with BPA that I can't find now, and this cute article from January in JAMA about nematodes and BPA. I avoid gluten (for the most part) due to some skin effects and general creepiness, and I don't see why I should feel differently about estrogenic compounds leaching from plastics.

But no, I don't leap across the table and grab the Capri Sun out of my kid's hand at the birthday party either. Nor will I add a machete to my list of standard kitchen tools so that I can make coconut milk from scratch. I drink from a plastic-free water container at the gym and the next set of lunchbox containers will be metal… but life has to be lived. And at least I can worry about these things affecting my children, rather than tuberculosis, mines, or revolution.

I've been feeling the same way and have been trying to draw the line between obsessive and living a normal life. Pretty much all food products are scary these days. I do the best I can and try not to obsess too much.

I love the way you put it--LOL--trying to freak out sensibly as if they weren't mutually exclusive terms. I've been gradually replacing plastic dishes with glass and I tossed my grandson's favorite non-stick pan but I bought him a pretty, "shiny" stainless steel one and he calmed down. :-))

I drank water almost exclusively from a Nalgene bottle for at least a year. Towards the end of that year, I started having symptoms that strongly resembled my negative hormonal reaction to soy, which puzzled me exceedingly, since I had completely cut soy out of my diet. Then I read an article (in my local paper, of all places) about Nalgene bottles and BPA, so I stopped using the Nalgene bottle. It took several weeks, but the symptoms eventually faded. Whatever BPA was doing to my body, it very closely resembled what soy had done to me.

I now drink water from a 1 quart canning jar (with a plastic lid). I get the occasional comment about moonshine, but otherwise it works out well for me.

Nance,Stainless-steel pan is not a substitute for non-stick one for some preparations. It is fine for chicken or sauteed veggies, but can be too sticky for fries or fish. I found that ceramic-coated pans are very convenient and not expensive(I got mine from the Ross). If you get for your grand-son a good vintage cast-iron from ebay and season it properly, it will last forever while getting better every year.

I pick my fights... I use lots of glass and stainless steel, and try not to use many plastics beyond my BPA-free bidon for the bike. The elephant in the room for me is my can-a-day coconut cream addiction... The cans are most probably loaded with BPA. I'll keep my eyes open for alternatives, but in our Brave New World, I'm prepared to take a hit there in order to benefit from my daily MCFA dose.

Given the articles that you cited, plastic can be some scary stuff. I think that with food, plastics can be avoided to a large degree, but the biggest hurdle I'm finding is meat. Whether I buy my meat from the farmers market, co-op, or grocery store, it's all coming to me packaged in plastic. Doesn't matter what kind. I'd love to buy water in glass bottles only, but that would leave me in the poor house, so I'm stuck with drinking water bottled in plastic. It's better than the alternative of being sick from drinking filtered tap water, but again less than ideal. I think we all do what we can to lead the healthiest lives possible, but life isn't perfect.

I agree we definitely have to pick our battles! Of course I worry that BPA-free bottles have other estrogenic compounds that we know less about - at least BPA leaves the body in a few days.

Gabriel - I don't worry too much about microwaving. Jaminet and Sisson have a few posts on it with some linked research. However, I microwave in glass or ceramic exclusively.

Funnyeater - most commercial bottled drinking water is tap water that has been bottled. There are exceptions, of course (and I buy bottled mineral water, and try to get it in glass bottles, which usually requires a trip to Whole Foods). Of course there are the plastic filters and plastic tubing in the refrigerator and all sorts of things to worry about if you really want to. Hey, it could be worse. It could be lead!

William - thanks for the link! Very useful. Mostly I use coconut milk in curries (which I think I could substitute my glass bottled coconut butter with added water) or in smoothies, and I suppose I could whip up some on the spot for smoothies.

Mario - thanks, that is good to know!

All - we could spend all our time worrying about something or other. I think given some of the suspicious research findings that it is prudent to try to avoid eating plastics when possible. But there is no smoking gun - just like with gluten!

add metal sardine and oyster cans to the list of things I worry about. I love he Planet Box all stainless steel lunch boxes I discovered via Sarah Fragoso's podcast. They come with different magnetic "stickers" to personalize the outside and so my 1st grader has lots of jealous class mates.

Jamie - You can get coconut cream in a bottle: Artisana (it's called coconut butter but it's the same thing as coconut cream). I like to eat it from the bottle too -- it satisfies my sweet tooth since I don't eat sugar. You can get it from Amazon or even cheaper at some other sites. Here's the Amazon link: http://www.amazon.com/Artisana-100%25-Organic-Coconut-Butter/dp/B000WV153I/ref=sr_1_1?s=grocery&ie=UTF8&qid=1319294859&sr=1-1

I buy Native Forest organic coconut milk (also from Amazon). It doesn't answer all the concerns raised on the site Emily provided (it has guar gum in it and, yes, we don't know the source of the water) but the cans are BPA-free and since guar gum doesn't seem to bother me, I use it a lot -- in smoothies mostly.

Toni beat me to it. I was going to mention that Native Forest brand coconut milk is in BPA free cans, and is quite good coconut milk. I don't know why anyone would object to guar gum, as it is a natural emulsifier/thickener that also functions as a prebiotic fiber. It is added to prevent separation.I get my tomato paste in jars, so the coconut milk is the only canned product in the kitchen.

Toni - In New Zealand, coconut cream is a very thick and less watery version of coconut milk. What you are referring to is coconut butter, which we do get in glass jars. The good news is, with a bit of digging, it looks like the coconut cream I get is in BPA-free cans.

Ellyn Satter explains the recent BPA and canned soup situation: Ellyn Satter AssociatesBPA and canned foods. In her November 25 post, Amy Davenport Holtgren wonders if we should be cautious about eating canned food, based on the Carwile JAMA 305:2218-2220 article (and media flap) about high levels of urinary BPA after canned soup consumption. As Amy and I suspected, spin. Thanks to Ines Anchondo’s sleuthing, posted below is a sensible analysis of the JAMA article, the BPA issue, and other, more-responsible research. As you will see if you read the Butterworth article carefully and follow the hyperlinks, the Carwile BPA flap is a textbook case of media-grabbing inaccurate reporting.

What is the bottom line? In my not-so-humble-opinion, there is no reason to stop eating canned foods. The following two points, for me, are persuasive: 1) The JAMA study found high BPA levels in the urine because BPA is eliminated very rapidly. If it is in the urine, it doesn’t hurt you. 2) BPA is excreted by the body so rapidly that people on very high BPA diets have undetectable blood levels of biologically active (bioactive) BPA. If BPA is, indeed, harmful (the evidence is not in), it has to be in the blood and it has to be in a bioactive form.

Why do I care about this? Because such researcher-media tactics gain attention by exploiting people’s fear of food. Being afraid of food, in turn, takes away the joy of eating and undermines eating competence. If in doubt, keep in mind that in the long run, it is better to eat than to avoid. – Ellyn -

Harvard Prof Spins Scary Soup Study: Media Swallow - Forbeswww.forbes.comImage via Wikipedia Imagine three of the top scientific agencies in the U.S. working with one of the nation's top research laboratories try to find out how much BPA you are exposed to when you eat a lot of canned food over 24-hours. Imagine they continuously measure blood and urine to [...]

Emily, the machete is for coconut WATER, not coconut milk! And it is so totally worth it. I say this even after having broken my mother's prized machete-looking butcher knife on a fresh coconut. Electrolytes + sugar have never had a marriage higher in reward.

Another review:Phthalates and BPA: Of Mice and Men -Harriet Hallhttp://www.sciencebasedmedicine.org/index.php/phthalates-and-bpa-of-mice-and-men/Conclusion:In my opinion, current evidence might be sufficient to justify banning phthalates and BPA for mice, but not for men. I’m not going stop eating canned food, and I’m not about to throw my rubber ducky away.

In New Zealand, coconut cream is a thicker version of coconut milk - what dairy cream is to dairy milk. What you refer to as both coconut cream & coconut butter, we call coconut butter or creamed coconut.

I found out that the Trident brand of coconut cream is in BPA-free cans. So sensible freaking out over!

They say that the recent Vandenberg study (PUBMED 20338858) that reviews >80 published articles of groups around the world (!!) that measured detectable BPA in urine, blood, fetal cord blood, placenta, etc were not plausible(!) and probably a result of contamination:

Its not really possible to avoid BPA by black listing particular sources as you don't know the exact manufacturing procedure of product you bought.

The best option is to provide to the body what it needs to get rid of toxins. It looks like even vitamin C isn't of much help here (some studies report its aggravates BPA toxicity in rats, some the opposite) but NAC seems is protective (NAC treatment also attenuated the BPA-induced increased MDA levels and decreased GSH levels in brain. Results of the present study show that NAC has potential to reverse cognitive dysfunction and oxidative stress induced by BPA exposure in rats)

My only potential source of BPA is canned salmon twice a week. I'M FREAKING OUT ABOUT IT, but sensibly (thanks for the suggestion!) because there isn't much I can do about it. I could pay more for fresh salmon, but that's just not worth it. I'm not eating canned our plastic bottled stuff, good enough.

What no music links in the post? I've enjoyed reading your posts since I discovered you in 2011.

I'd like to suggest a song. Here is an unexpected hit from the Pogues from 1987 that was boffo big in the UK and Ireland and still is. One of my favs that I forgot about. The first minute is slow but it picks up. The video has a cameo by Matt Dillon. It is also probably the only Xmas song with the word maggot in it. All the best in 2012.

@Ines, I'm not waiting for business magazines and government agencies (in bed with industrial agriculture) to prove which foods are safe. Even as a child in the 70s I could figure out for myself that partially hydrogenated margarine is not food. Clearly BPA isn't either. I'm teaching my children to eat real food: raw dairy, pastured meats, fresh organic fruits, veggies, and grains. The rest of it, no matter what Forbes says is safe, is not food.

Another lovely thing happens when you eliminate plastic from your kitchen, you reduce pollution, our country' dependence on oil, and processed foods. Also, you are more likely to be spending your food dollars on fresh local food, so taking money away from industrial agriculture and returning it to your community. How many win is that? A bunch.

I'm wondering if what BPA is really a marker for is a junk diet. Poor emotional control is a rather nebulous symptom. It could be just that people with higher BPA in their urine are also the people that are eating more junk, and less real food. I know that kind of diet can give me poor emotional control. Just a thought.

I've had a few questions about elements of this post - hopefully this comment can clarify:

BPA and the other estrogenic compounds are definitely leached into foods exposed to plastic, the danger from this leaching is unproven and unknown. It seems prudent to avoid them (not to mention that most processed and canned foods aren't worth eating anyway for many other reasons), and I don't think avoiding them as is practical is the same as being "afraid of food." All the human behavior studies I have read about BPA are observational, meaning causation cannot be established. It would make sense that people eating more processed food have more BPA, and thus BPA is indeed a marker for a crappier diet - an obvious confounder.

As a general rule, heating and stressing of the plastic will increase the leaching, an acidic compound such as tomato sauce will increase the leaching. Liquids will have more molecules swimming around to increase leaching, whereas a relative solid will not, and higher temps mean the molecules swim around more rapidly.

Thus I can't be bothered to worried about things like meat surface wrapped in plastic - my meat comes frozen anyway - not much leaching should occur when the molecules are slowed down by freezing.

I also don't worry so much about plastic plates, those kinds of things - I avoid heating liquids in plastic and putting screaming hot food on plastic. I'm moving more towards stainless steel and ceramic for the kids, but I'm not 100% there yet...

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About Me

Emily Deans, M.D.: I'm a psychiatrist in Massachusetts searching for evolutionary solutions to the general and mental health problems of the 21st century. Disclaimer: This information is for educational purposes only, and is in no way intended to be personal medical advice. Please ask your physician about any health guidelines seen in this blog, as everyone is different in his or her medical needs.